Tear Trough vs. Sunken Eyes

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At Castleknock Cosmetic Clinic Dublin we use dermal fillers under the eyes to help with the problem of bags is typically trying to fill in the depressed curve that forms between the cheek and the bag. I also build up the cheek to help smooth the area between the bag and cheek. The goal is to fill the tear trough below the bag and lift the cheek to provide a more natural support and contour between the two, effectively masking the appearance of the bag.

In the sandwich technique used in the SoftLift, an advanced mix of dermal fillers is placed above the periosteum (deeper than some other facial areas) from the cheek to the infraorbital rim (the bone below the eye socket). Restylane Sub-Q, Radiesse, and Juvéderm Volume can be effective fillers in this area because it can provide the necessary bulk and then assists in bulk lifting the area. Lighter dermal fillers like Restylane Touch, Teosyal Global and Juvéderm 2 are placed in the superficial area giving a soft feel and natural texture.

In most facial areas, dermal fillers are placed with what are known as threading or tunnelling injection methods. In the cheek area, some I prefer a coning cannula technique with some of the dermal fillers. This method places the dermal filler perpendicular to the delicate area around the eyes, placing it deep so that the cones of fillers push up on the skin. As with the tunneling technique, the dermal fillers are not visible underneath the skin.

Sunken eyes and dark circles are treated much the same as bags are treated. The goal is to fill in the cheek and part of the deficit under the infraorbital rim, which can provide a shapelier contour and in many instances nearly eliminate the hollow, gaunt appearance.

Various theories are propounded about the cause of dark circles. Some literature points to vascular issues. Some say it is a light refraction issue caused by either bulging bags or sunken hollows. In any event, the dermal filler procedures mentioned in the section above will have some effect on dark circles below the eyes and in the tear trough. Some patients report astonishing knocking back the year’s results.

Dr Házem Kahlout
MB, BCh, MBCAM, LRCPI, LRCSI, BAO(NUI), DPM
Dr. Házem Kahlout is the Medical Director of Castleknock Cosmetic Clinic, Laser Surgery & Medical Aesthetics. He is a graduate of the Royal College of Surgeons in Ireland, 1989. He was trained in the use of medical aesthetics internationally at Harley Street, London, hands on by pillars of the industry.
He is a member of the:
Irish Association of Cosmetic Doctors (Founding Member)
British Association of Cosmetic Doctors (BACD)
American Academy of Aesthetic Medicine (AAAM)
National Council of Laser Excellence (NCLE)
Union Internationale De Medicine Esthetique (UIME)
Certified Member of Network-Lipolysis
British Association of Body Sculpting, (BABS)
European Academy of Aesthetic Medicine
He is a fully registered practitioner with the Medical Council of Ireland and the General Medical Council in the UK.
Dr Kahlout practices aesthetic medicine as opposed to cosmetic surgery and all treatments are walk in/walk out without the need for general anesthetic or overnight hospital stay.
Castleknock Cosmetic Clinic was one of the first clinics in the Ireland to specifically focus on non invasive or minimally invasive aesthetic medical treatments.
In 2012 he was invited to be part of the cosmetic interventions working group that is consulting with HSE to improve standards with the cosmetic industry in Ireland.
Dr. Kahlout is an accredited Appraiser for the BACD and the General Medical Council in the UK overseeing the adequate performance of aesthetic doctors. Dr Kahlout has been practicing Aesthetic Medicine since 1998 and Castleknock Cosmetic Clinic was established in 2001.